AKHSA SIMONOVICH (FNP) – Family Nurse Practitioner, NPI 1003599614

AKHSA SIMONOVICH (FNP) is a healthcare provider. based in St louis park, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 10583 (MN). The NPI Number for AKHSA SIMONOVICH (FNP) is 1003599614

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
AKHSA SIMONOVICH (FNP)
NPI
1003599614
Phone
(952) 345-8770
Address
5320 W 23RD ST STE 130
Enumeration Date
9 August 2023
Last Update Date
5 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2023 (3 years ago)
PAC ID
0244675072
Group Practice PAC ID
6204938350
Professional Enrollment ID
I20240301003056
Address ID
MN554164728ST4201XBLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for AKHSA SIMONOVICH (FNP)

  • 5320 W 23RD ST STE 130

    ST LOUIS PARK, MN 554161670

    Phone: (952) 345-8770

    Type: Location

  • 4201 Excelsior Blvd

    St Louis Park, MN 554164728

    Phone: (952) 933-8900

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-03-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240301003056INurse PractitionerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55416)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204938350View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to AKHSA SIMONOVICH (FNP)?
NPI 1003599614 is assigned to AKHSA SIMONOVICH (FNP) under the national enumeration system.
Is AKHSA SIMONOVICH (FNP) active in the national directory?
AKHSA SIMONOVICH (FNP)'s public NPI profile is in an active state.
What field does AKHSA SIMONOVICH (FNP) work in?
You can think of AKHSA SIMONOVICH (FNP) as practicing within Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for AKHSA SIMONOVICH (FNP)?
We surface St Louis Park, Minnesota for AKHSA SIMONOVICH (FNP) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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